athenahealth Revenue Cycle Management (RCM) solutions integrate both front-end and back-office knowledge and support into the practice workflow including tasks such as patient scheduling, claims submission and tracking, and researching and implementing real-time updates to payer rules.
Independent medical practices are facing an increased administrative burden that could potentially cause an operational crisis. But typical revenue cycle management solutions are not properly equipped to meet the demands of practicing medicine in a new, value-based healthcare environment. New payment models require a healthcare revenue cycle management system that can track—and submit—cost and quality data, as well as process and appropriately distribute compensation based on practice performance.
Revenue Cycle Management Solution
- Efficient delegation of patient scheduling, billing, invoicing, claims processing, and other revenue cycle management activities to keep denials low, days in accounts receivable (DAR) down, and the practice focused on patient care
- Ongoing visibility into financial performance, so practices can make improvements and plan intelligently for the future
- The ability to reconcile group and individual payments against services provided, to track costs and outcomes
- The ability to take in lump sum payments, and allocate those to appropriate staff according to contract terms
- Close coordination with electronic health record (EHR) software to link clinical and financial outcomes, demonstrate success and identify where improvements are needed to maximize reimbursement and provide the highest quality patient care
1 Centers for Medicare & Medicaid Services; Office of the National Coordinator for Health Information Technology
2 athena Net data as of December 31, 2016
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